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Probert F, Yeo T, Zhou Y, Sealey M, Arora S, Palace J, Claridge TDW, Hillenbrand R, Oechtering J, Kuhle J, Leppert D, Anthony DC. Corrigendum: Determination of CSF GFAP, CCN5, and vWF levels enhances the diagnostic accuracy of clinically defined MS from non-MS patients with CSF oligoclonal bands. Front Immunol 2022; 13:1095038. [PMID: 36582251 PMCID: PMC9793797 DOI: 10.3389/fimmu.2022.1095038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 11/11/2022] [Indexed: 12/15/2022] Open
Abstract
[This corrects the article DOI: 10.3389/fimmu.2021.811351.].
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Affiliation(s)
- Fay Probert
- Department of Chemistry, University of Oxford, Oxford, United Kingdom,*Correspondence: Daniel C. Anthony, ; Fay Probert, fay.probert@p harm.ox.ac.uk
| | - Tianrong Yeo
- Department of Pharmacology, University of Oxford, Oxford, United Kingdom,Department of Neurology, National Neuroscience Institute, Singapore, Singapore,Duke-National University of Singapore (NUS) Medical School, Singapore, Singapore
| | - Yifan Zhou
- Department of Pharmacology, University of Oxford, Oxford, United Kingdom,Translational Stem Cell Biology Branch, National Institutes of Health, Bethesda, MD, United States,Wellcome Medical Research Council (MRC) Trust Stem Cell Institute, University of Cambridge, Cambridge, United Kingdom
| | - Megan Sealey
- Department of Pharmacology, University of Oxford, Oxford, United Kingdom
| | - Siddharth Arora
- Department of Mathematics, University of Oxford, Oxford, United Kingdom
| | - Jacqueline Palace
- Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford, Oxford, United Kingdom
| | | | | | - Johanna Oechtering
- Neurologic Clinic and Policlinic, Multiple Sclerosis (MS) Center and Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB), Departments of Clinical Research and Biomedicine, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Jens Kuhle
- Neurologic Clinic and Policlinic, Multiple Sclerosis (MS) Center and Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB), Departments of Clinical Research and Biomedicine, University Hospital Basel, University of Basel, Basel, Switzerland
| | - David Leppert
- Neurologic Clinic and Policlinic, Multiple Sclerosis (MS) Center and Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB), Departments of Clinical Research and Biomedicine, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Daniel C. Anthony
- Department of Pharmacology, University of Oxford, Oxford, United Kingdom,*Correspondence: Daniel C. Anthony, ; Fay Probert, fay.probert@p harm.ox.ac.uk
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Castillo-Villalba J, Gil-Perotín S, Gasque-Rubio R, Cubas-Nuñez L, Carratalà-Boscà S, Alcalá C, Quintanilla-Bordás C, Pérez-Miralles F, Ferrer C, Cañada Martínez A, Tortosa J, Solís-Tarazona L, Campos L, Leivas A, Laíz Marro B, Casanova B. High Levels of Cerebrospinal Fluid Kappa Free Light Chains Relate to IgM Intrathecal Synthesis and Might Have Prognostic Implications in Relapsing Multiple Sclerosis. Front Immunol 2022; 13:827738. [PMID: 35330910 PMCID: PMC8940299 DOI: 10.3389/fimmu.2022.827738] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 02/07/2022] [Indexed: 11/13/2022] Open
Abstract
Cerebrospinal kappa free light chain (KFLC)-index is a marker of intrathecal immunoglobulin synthesis that aids in the diagnosis of multiple sclerosis (MS). However, little evidence exists on its prognostic role. Our aim is to analyze the relationship between KFLC-index and other MS biomarkers and to explore its prognostic role. This is a monocentric observational study in a cohort of 52 people with relapsing MS (pwRMS) performed on prospectively acquired clinical data and with retrospective evaluation of biomarkers. We measured KFLC-index, immunoglobulin intrathecal synthesis, cerebrospinal fluid (CSF) chitinase 3-like 1 (CHI3L1), and neurofilament light protein (NFL) and reviewed MRI to detect leptomeningeal contrast enhancement (LMCE). We compared time to Expanded Disability Status Scale (EDSS) 3 and to initiation of high-efficacy disease-modifying therapies (heDMTs) by multivariate Cox regression analysis. Median KFLC-index correlated with IgG/IgM indexes (p < 0.0001/p < 0.05) and IgG-oligoclonal bands (OCGBs) (p < 0.001). Patients with IgM-oligoclonal bands (OCMBs) had a higher KFLC-index (p = 0.049). KFLC-index was higher in patients with LMCE (p = 0.008) and correlated with CHI3L1 (p = 0.007), but disease activity had no effect on its value. Bivariate and multivariate analyses confirmed KFLC-index > 58 as an independent risk factor for reaching an EDSS of 3 (hazard ratio (HR) = 12.4; 95% CI = 1.1-147; p = 0.047) and for the need of treatment with heDMTs (HR = 3.0; 95% CI = 1.2-7.1; p = 0.0013). To conclude, our data suggest a potential prognostic role of the KFLC-index during the MS course.
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Affiliation(s)
- Jéssica Castillo-Villalba
- Neuroimmunology Unit, Neurology Department and Health Research Institute, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Sara Gil-Perotín
- Neuroimmunology Unit, Neurology Department and Health Research Institute, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Raquel Gasque-Rubio
- Neuroimmunology Unit, Neurology Department and Health Research Institute, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Laura Cubas-Nuñez
- Neuroimmunology Unit, Neurology Department and Health Research Institute, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Sara Carratalà-Boscà
- Neuroimmunology Unit, Neurology Department and Health Research Institute, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Carmen Alcalá
- Neuroimmunology Unit, Neurology Department and Health Research Institute, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Carlos Quintanilla-Bordás
- Neuroimmunology Unit, Neurology Department and Health Research Institute, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Francisco Pérez-Miralles
- Neuroimmunology Unit, Neurology Department and Health Research Institute, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Cristina Ferrer
- Neuroimmunology Unit, Neurology Department and Health Research Institute, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Antonio Cañada Martínez
- Data Science, Biostatistics and Bioinformatics, Health Research Institute, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Jordi Tortosa
- Clinical Laboratory, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | | | - Luisa Campos
- Scientific Department, The Binding Site Iberia, Barcelona, Spain
| | - Alberto Leivas
- Scientific Department, The Binding Site Iberia, Barcelona, Spain
| | - Begoña Laíz Marro
- Clinical Laboratory, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Bonaventura Casanova
- Neuroimmunology Unit, Neurology Department and Health Research Institute, Hospital Universitario y Politécnico La Fe, Valencia, Spain
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Neilson LE, Hollen C, Hiller A, Wooliscroft L. Oligoclonal Bands in Multiple System Atrophy: Case Report and Proposed Mechanisms of Immunogenicity. Front Neurosci 2022; 16:852939. [PMID: 35295090 PMCID: PMC8919426 DOI: 10.3389/fnins.2022.852939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 02/07/2022] [Indexed: 11/13/2022] Open
Abstract
Multiple System Atrophy (MSA) is a neurodegenerative disease with heterogeneous manifestations and is therefore difficult to diagnose definitively. Because of this, oftentimes an extensive workup for mimickers is undertaken. We herein report a case where the history and cerebrospinal fluid (CSF) findings of oligoclonal bands suggested an inflammatory disorder. Immunomodulatory therapy failed to ameliorate symptoms or alter the trajectory of continued physical decline, prompting re-visitation of the diagnosis. Oligoclonal bands, while generally viewed as specific to multiple sclerosis or other inflammatory conditions, may be seen in other disease processes. Therefore, this finding should not exclude consideration of neurodegenerative disease.
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Affiliation(s)
- Lee E Neilson
- Department of Neurology, Veterans Affairs Medical Center, Portland, OR, United States.,Department of Neurology, Oregon Health and Sciences University, Portland, OR, United States
| | - Christopher Hollen
- Department of Neurology, Veterans Affairs Medical Center, Portland, OR, United States.,Department of Neurology, Oregon Health and Sciences University, Portland, OR, United States
| | - Amie Hiller
- Department of Neurology, Veterans Affairs Medical Center, Portland, OR, United States.,Department of Neurology, Oregon Health and Sciences University, Portland, OR, United States
| | - Lindsey Wooliscroft
- Department of Neurology, Veterans Affairs Medical Center, Portland, OR, United States.,Department of Neurology, Oregon Health and Sciences University, Portland, OR, United States
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Probert F, Yeo T, Zhou Y, Sealey M, Arora S, Palace J, Claridge TDW, Hillenbrand R, Oechtering J, Kuhle J, Leppert D, Anthony DC. Determination of CSF GFAP, CCN5, and vWF Levels Enhances the Diagnostic Accuracy of Clinically Defined MS From Non-MS Patients With CSF Oligoclonal Bands. Front Immunol 2022; 12:811351. [PMID: 35185866 PMCID: PMC8855362 DOI: 10.3389/fimmu.2021.811351] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 12/27/2021] [Indexed: 12/31/2022] Open
Abstract
Background Inclusion of cerebrospinal fluid (CSF) oligoclonal IgG bands (OCGB) in the revised McDonald criteria increases the sensitivity of diagnosis when dissemination in time (DIT) cannot be proven. While OCGB negative patients are unlikely to develop clinically definite (CD) MS, OCGB positivity may lead to an erroneous diagnosis in conditions that present similarly, such as neuromyelitis optica spectrum disorders (NMOSD) or neurosarcoidosis. Objective To identify specific, OCGB-complementary, biomarkers to improve diagnostic accuracy in OCGB positive patients. Methods We analysed the CSF metabolome and proteome of CDMS (n=41) and confirmed non-MS patients (n=64) comprising a range of CNS conditions routinely encountered in neurology clinics. Results OCGB discriminated between CDMS and non-MS with high sensitivity (85%), but low specificity (67%), as previously described. Machine learning methods revealed CCN5 levels provide greater accuracy, sensitivity, and specificity than OCGB (79%, +5%; 90%, +5%; and 72%, +5% respectively) while glial fibrillary acidic protein (GFAP) identified CDMS with 100% specificity (+33%). A multiomics approach improved accuracy further to 90% (+16%). Conclusion The measurement of a few additional CSF biomarkers could be used to complement OCGB and improve the specificity of MS diagnosis when clinical and radiological evidence of DIT is absent.
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Affiliation(s)
- Fay Probert
- Department of Chemistry, University of Oxford, Oxford, United Kingdom,*Correspondence: Daniel C. Anthony, ; Fay Probert,
| | - Tianrong Yeo
- Department of Pharmacology, University of Oxford, Oxford, United Kingdom,Department of Neurology, National Neuroscience Institute, Singapore, Singapore,Duke-National University of Singapore (NUS) Medical School, Singapore, Singapore
| | - Yifan Zhou
- Department of Pharmacology, University of Oxford, Oxford, United Kingdom,Translational Stem Cell Biology Branch, National Institutes of Health, Bethesda, MD, United States,Wellcome Medical Research Council (MRC) Trust Stem Cell Institute, University of Cambridge, Cambridge, United Kingdom
| | - Megan Sealey
- Department of Pharmacology, University of Oxford, Oxford, United Kingdom
| | - Siddharth Arora
- Department of Mathematics, University of Oxford, Oxford, United Kingdom
| | - Jacqueline Palace
- Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford, Oxford, United Kingdom
| | | | | | - Johanna Oechtering
- Neurologic Clinic and Policlinic, Multiple Sclerosis (MS) Center and Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB), Departments of Clinical Research and Biomedicine, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Jens Kuhle
- Neurologic Clinic and Policlinic, Multiple Sclerosis (MS) Center and Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB), Departments of Clinical Research and Biomedicine, University Hospital Basel, University of Basel, Basel, Switzerland
| | - David Leppert
- Neurologic Clinic and Policlinic, Multiple Sclerosis (MS) Center and Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB), Departments of Clinical Research and Biomedicine, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Daniel C. Anthony
- Department of Pharmacology, University of Oxford, Oxford, United Kingdom,*Correspondence: Daniel C. Anthony, ; Fay Probert,
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Banerjee TK, Saha M, Ghosh E, Hazra A, Das A, Choudhury D, Ojha S, Haldar A, Mukherjee A, Nandi SS, Ghosh A, Mukherjee A, Chatterjee A, Datta A, Purakayastha S. Conversion of clinically isolated syndrome to multiple sclerosis: a prospective multi-center study in Eastern India. Mult Scler J Exp Transl Clin 2019; 5:2055217319849721. [PMID: 31236283 PMCID: PMC6572895 DOI: 10.1177/2055217319849721] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2018] [Revised: 04/05/2019] [Accepted: 04/16/2019] [Indexed: 11/17/2022] Open
Abstract
Background In White populations more than 60% of clinically isolated syndrome (CIS) convert to multiple sclerosis (MS) on a long-term follow-up; several predictors for conversion have been identified. Objective This study aimed to determine the conversion rate and the predictors of conversion from CIS to MS (McDonald 2010) among Indians. The other objective was to evaluate the diagnostic accuracy of the new McDonald 2017 criteria in prediction of a second clinical attack. Methods Clinical and demographic data of CIS cohorts were collected. Baseline investigations included cerebrospinal magnetic resonance imaging (MRI) with contrast and cerebrospinal fluid (CSF) testing for oligoclonal band (OCB). Follow-up clinical and MRI examinations were performed annually for at least 24 months. Results Of the 82 subjects (age range 15-58 years), 36 (43.9%) converted to MS; 31/82 (37.8%) converted in 24 months. The predictors for conversion were earlier age of onset, CSF-OCB, cerebral MRI T2 lesion count, and periventricular and juxtacortical location of lesions. Twenty-two (26.83%) CIS fulfilled the McDonald MS 2017 criteria at baseline. Conclusion In this first prospective study of CIS in India, the risk factors for conversion are similar but the conversion rate to MS is lower than that in the western nations.
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Affiliation(s)
- T K Banerjee
- National Neurosciences Centre Calcutta, Kolkata, India
| | - M Saha
- Apollo Gleneagles Hospital, Kolkata, India
| | - E Ghosh
- National Neurosciences Centre Calcutta, Kolkata, India
| | - A Hazra
- Institute of Postgraduate Medical Education & Research, Kolkata, India
| | - A Das
- National Neurosciences Centre Calcutta, Kolkata, India
| | - D Choudhury
- National Neurosciences Centre Calcutta, Kolkata, India
| | - S Ojha
- National Neurosciences Centre Calcutta, Kolkata, India
| | | | - A Mukherjee
- Vivekananda Institute of Medical Sciences, Kolkata, India
| | - S S Nandi
- Calcutta Medical Research Institute, Kolkata, India
| | - A Ghosh
- Apollo Gleneagles Hospital, Kolkata, India
| | - A Mukherjee
- Calcutta Medical Research Institute, Kolkata, India
| | - A Chatterjee
- Calcutta Medical Research Institute, Kolkata, India
| | - A Datta
- Institute of Neuroscience Kolkata, Kolkata, India
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